Thursday, November 01, 2007

Tracking stateside post-deployment incidents such as domestic violence, police standoffs, and all the rest including suicide, has been something that I have been a vocal proponent of. My work on the PTSD Timeline, in fact, officially kicks off again today, and in the coming weeks you'll see (far too many) new additions.

Hundreds of troops have come home from war, left the military and committed suicide.

That is the finding of preliminary Veterans Affairs Department research obtained by The Associated Press that provides the first quantitative look at the suicide toll on today's combat veterans. The ongoing research reveals that at least 283 combat veterans who left the military between the start of the war in Afghanistan on Oct. 7, 2001, and the end of 2005 took their own lives.

The numbers, while not dramatically different from society as a whole, are reminiscent of the increased suicide risk among returning soldiers in the Vietnam era. Today's homefront suicide tally is running at least double the number of troop suicides in the war zones as thousands of men and women return with disabling injuries and mental health disorders that put them at higher risk.

A total of 147 troops have killed themselves in Iraq and Afghanistan since the wars began, according to the Defense Manpower Data Center, which tracks casualties for the Pentagon.

Add the number of returning veterans and the finding is that at least 430 of the 1.5 million troops who have fought in the two wars have killed themselves over the past six years. And that doesn't include those who committed suicide after their combat tour ended and while still in the military — a number the Pentagon says it doesn't track.

That compares with at least 4,229 U.S. military deaths overall since the wars started — 3,842 in Iraq and 387 in and around Afghanistan.

So, while these figures are bad -- the problem is actually much worse. Continuing:

"None of them come back without being touched a little," said Mary Gallagher, a mother of three whose husband, Marine Gunnery Sgt. James Gallagher, took his own life in 2006 inside their home at Camp Pendleton, Calif.

He was proud of his Iraq service, but she wonders whether he was bothered by the death of his captain in Iraq or an incident in which he helped rescue a soldier who was in a fire and later died. Shortly before his death, her husband was distraught over an assignment change he saw as an insult, she said.

"His death contradicts the very person he was. It's very confusing and difficult to understand," said Gallagher of Lynbrook, N.Y.

The family of another Iraq veteran who committed suicide, Jeffrey Lucey, 23, of Belchertown, Mass., filed suit against the former VA secretary, alleging that bad care at the VA was to blame.

And the family of Joshua Omvig, a 22-year-old Iraq war veteran from Davenport, Iowa, who also committed suicide, successfully pushed Congress to pass a bill that President Bush is expected to sign that requires the VA to improve suicide prevention care.

Suicides in Iraq have occurred since the early days of the wars, but awareness was heightened when the Army said its suicide rate in 2006 rose to 17.3 per 100,000 troops — the highest level in 26 years of record-keeping.

That compares with 9.3 per 100,000 for all military services combined in 2006 and 11.1 per 100,000 for the general U.S. population in 2004, the latest year statistics were available. The Army has said the civilian rate for the same age and gender mix as in the Army is 19 to 20 per 100,000 people.

More stats, and a quote by author Penny Coleman:

At the VA's national suicide hot line center based in Canandaigua, N.Y., counselors have taken more than 9,000 calls since July. Some callers are just looking for someone to talk to. Others are concerned family members. Callers who choose to give their names can opt to be met at a local VA center by a suicide prevention counselor; more than 120 callers have been rescued by emergency personnel — some after swallowing pills or with a gun nearby, according to the center.

"It's sad, but I think in the other way it's very exciting because already we've seen really sort of people being able to change their lives around because of the access to resources they've been able to get," said Jan Kemp, who oversees the call center.

Penny Coleman, whose ex-husband committed suicide after returning from Vietnam, said she doesn't buy what she calls the "we didn't expect this" mentality about suicide.

"If you'd chosen to pay attention after Vietnam you would have and should have anticipated it would happen again," said Coleman, who published a book on the subject last year.

One more chunk includes a few more stats and a good quote:

From 20 percent to 50 percent of active duty troops and reservists who returned from war reported psychological problems, relationship problems, depression and symptoms of stress reactions, but most report that they have not sought help, according to a report from a military mental health task force.

"It's only when it becomes painful will someone seek counseling," said Chris Ayres, manager of the combat stress recovery program at the Wounded Warrior Project, a private veterans' assistance group based in Jacksonville, Fla. "That's usually how it happens. Nobody just walks in, because it's the hardest thing for a male, a Marine, a type-A personality figure to just go in there and say, 'Hey, I need some help.'"

While not suicidal, Ayres, 37, a former Marine captain from the Houston area who had the back of his right leg blown off in Iraq, has experienced episodes related to his post-traumatic stress disorder and said he worried about being stigmatized if he got help.

He's since learned to manage through counseling, and he's encouraging other veterans to get help.

Ayres is among 28,000 Americans injured in the war, more than 3,000 seriously.

In a study published earlier this year, researchers at Portland State University in Oregon found veterans were twice as likely to commit suicide as male nonveterans. High gun ownership rates, along with debilitating injuries and mental health disorders, were all risk factors that seemed to put the veterans at greater risk, said Mark Kaplan, one of the researchers.

While veterans from Iraq and Afghanistan were not included in the study, Kaplan said that given the nature of the injuries of the recent wars and the strain of long and repeated deployments, the newer generation of veterans could be at risk for suicide.

Kaplan said primary care physicians should ask patients whether they are veterans, and if the answer is yes, inquire about their mental health.

"This is war unlike other wars and we don't know the long-term implications and the hidden injuries of war," Kaplan said.

Ensuring the resources are in place when the troops need them is the key. The VA is ramping up in this area admirably after busted budgets held back necessary resources for years.

The point isn't that suicides are taking place in the veteran population. As the article states, suicide is found in the civilian population as well. But once such a suicide occurs, the next question must be: Can we confidently look through that service member's health care records and see that everything that should have -- much less could have -- been done to help them, was?

If we've done what we should and could, then at least we know that we met our responsibility to providing the reintegration support they deserve when they needed it most.

While a wide variety of events can trigger what's called post-traumatic stress disorder, this PTSD blog focuses solely on the combat-related variety.
As a new generation of warriors returns to civilian life and seeks out resources, PTSD Combat is here to help.

Considerable Quotes

"The first shamans earned their keep in primitave societies by providing explanations and rituals that enabled man to deal with his environment and his personal anguish. Early man, no less than we, dealt with forces that he could not understand or control, and he attempted to come to grips with his vulnerablity by trying to bring order to his universe." -- Richard Gabriel in No More Heroes

"War stories end when the battle is over or when the soldier comes home. In real life, there are no moments amid smoldering hilltops for tranquil introspection. When the war is over, you pick up your gear, walk down the hill and back into the world." -- OIF vet John Crawford in The Last True Story I'll Ever Tell

"After wars' end, soldiers once again become civilians and return to their families to try to pick up where they left off. It is this process of readjustment that has more often than not been ignored by society. -- Major Robert H. Stretch, Ph.D in Textbook of Military Medicine: Vol. 6 Combat Stress

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